The Coat Problem. Counterfactuals, Truth-makers, and Temporal specification

Standard semantic treatments of counterfactuals appeal to a relation of similarity between possible worlds. Similarity, however, is a vague notion. Lewis suggests reducing the vagueness of similarity by adopting a principle known as 'late departure' (LD): the more the past two worlds share, the more they are similar. LD has several virtues. However, as Bennett points out, a standard semantics based on LD suffers from the so-called coat problem. In a nutshell, we are led to assign counterintuitive truth-values to counterfactuals whose antecedent time is left underspecified. In the present paper, we argue that the coat problem may be solved by defining a time-sensitive notion of similarity. To illustrate, we assume a Priorean, tensed language, interpreted on branching-time frames in the usual, 'Ockhamist' way, and we enrich it with a counterfactual connective. Within this framework, we define a time-sensitive relation of similarity, based on Yablo's work on truth-makers and partial truth. In the resulting semantics, which has independent interest, the coat problem does not arise

The actual future is open

Open futurism is the indeterministic position according to which the future is 'open,' i.e., there is now no fact of the matter as to what future contingent events will actually obtain. Many open futurists hold a branching conception of time, in which a variety of possible futures exist. This paper introduces two challenges to (branching-time) open futurism, which are similar in spirit to a challenge posed by Kit Fine to (standard) tense realism. The paper argues that, to address the new challenges, open futurists must (i) adopt an objective, non-perspectival notion of actuality and (ii) subscribe to an A-theoretic, dynamic conception of reality. Moreover, given a natural understanding of "actual future," (iii) open futurism is naturally coupled with the view that a unique, objectively actual future exists, contrary to a common assumption in the current debate. The paper also contends that recognising the existence of a unique actual future helps open futurists to avoid potential misconceptions

Sjogren syndrome and parotid marginal zone lymphoma: Report of a case and review of literature

Five percent of the cancers in the parotid region are non-hodgkin lymphomas. This lymphoma, involving the mucosa-associated lymphoid tissue (MALT), is called MALToma. A chronic autoimmune inflammatory process of the parotid gland, such as Sjogren's syndrome, results in an increased incidence of parotid MALToma. Biopsy of the parotid is essential for appropriate diagnosis; this can then be completed by radiotherapy, chemotherapy or therapy with monoclonal antibodies according to the stage of the disease. This study shows a clinical case of a 50-year-old patient with Sjogren's syndrome who developed a parotid MALToma

Sialoendoscopy in the management of the salivary gland disorders

BACKGROUND: The aim of this study was to determine the long-term (> 6 month) outcome of patients suffering from obstructive sialadenitis treated by sialoendoscopy. METHODS: Between 2009 and 2013 seventy-six subjects underwent sialoendoscopy under local anesthesia at the University Hospital P. Giaccone of Palermo. RESULTS: The mean age of presentation was 50.5 years for male (56.6%) and 44.7 years for female (43.4%). The presenting symptoms were frequent pain in 72% of cases, frequent purulent secretions in 65% of cases, frequent swelling in 62% of cases and frequent bitter taste in 44% of cases. Affected glands were in 54 cases the submandibular unilaterally, in 21 cases the parotid unilaterally and in 1 case the submandibular bilaterally. Preoperative ultrasound showed in 30 cases a sialolitiasis and in 19 cases a ductal stenosis, in 3 cases were both associated. In 46 cases showed a ductal dilatation, variably combined with the previous two and in 13 cases ultrasound gave no indication. Average operating time was 60.7 minutes (range 35-125 min). In 35 cases it was necessary to perform a papillotomy. Presence of stones was shown in 36 patients, in 3 cases these stones were multiple. Endoscopic removal of stones was achieved in 72.2%, with a mean size of 3.6 mm (range 0.7-5.5 mm), only two were larger than 5 mm. In five of this cases was performed a trans-oral combined approach. In 15 cases was highlighted a ductal stenosis, in 6 cases associated with mucus plugs, that were treated with daily irrigations with Thiamphenicol glycinate acetylcysteinate. A percentage of 64.8% of patients had complete resolution of symptoms after sialendoscopy, with 25% having partial resolution of symptoms and 6.6% required the removal of the gland. CONCLUSIONS: Sialendoscopy is the procedure of choice for the diagnosis and treatment of chronic non-lithiasic sialoadenitis, but unlike its apparent simplicity has a significant learning curve, and need appropriate selection of patients

Future Contingents. Indeterminism, Temporal Logic and Semantics

This essay is about the problem of future contingents, that is, statements predicting future events that are neither historically impossible, nor inevitable. The analysis intersects metaphysics, logic, philosophy of language and philosophy of science. In particular, the essay explores why indeterminism – viz., the doctrine that the present, the past, and the laws of nature do not necessitate the future – may be taken as a sensible thesis. Furthermore, several semantics for indeterministic, modal temporal languages will be considered. It is argued that the modal, temporal logic that best fits indeterminism is a version that mirrors the so-called TRL metaphysics. The advocates of the TRL metaphysics, indeed, can evoke a substantive notion of actuality to tell themselves apart from determinist, many worlds theorists. And the notion of substantive actuality assumed by TRL theorists may be easily reflected at the (post)semantic level, yield- ing a temporal logic which meets several desiderata

Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study.

The aim of this study was to verify the efficacy and the safety of transtympanic dexamethasone to treat sudden sensorineural hearing loss as first and single drug method. Considering ethical implication of performing a mininvasive procedure on middle ear, we matched such proposed treatment with systemic prednisone administration that represents the widest adopted protocol. Randomized prospective study was conducted. The inclusion criterion was a sudden sensorineural hearing loss of at least 30 dB across three contiguous frequencies over a period of 24 h. Group A received transtympanic steroid injections; Group B received oral administration of steroids. 25 patients were treated with transtympanic therapy whereas 21 underwent systemic treatment. The mean of initial PTA was 59 dB for the whole series: 65 dB for group A and 51 dB for group B. The recovery better than 10 dB was obtained in 80% of patients of group A and in 17 81% of patients of group B, with a total of 80.5%. The mean relative gain in PTA was 41.16% in the group A and 44.7% in the group B. In the frequencies tested (0.5, 1, 2, and 4 kHz) PTA improvements after transtympanic treatment were higher than after systemic treatment, but these differences were not statistically significant (P = 0.61). Both transtympanic and systemic treatment had similar clinical recovery times. This prospective randomized clinical study showed good result in terms of hearing recovery, better than the expected results of the simple observation without treatment. We can consider transtympanic administration as a first line treatment, because of the statistical analysis confirmed similar results with systemic therapy, reducing possible side effects of systemic drug administration. The delay of treatment does not influence the outcome, allowing treating patients within 10 days of onset

Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: gender makes a difference

The ongoing COVID-19 pandemic highlighted a significant interplay between cardiovascular disease (CVD), COVID-19 related inflammatory status, and depression. Cardiovascular (CV) injury is responsible for a substantial percentage of COVID-19 deaths while COVID-19 social restrictions emerged as a non-negligible risk factor for CVD as well as a variety of mental health issues, and in particular, depression. Inflammation seems to be a shared condition between these two disorders. Gender represents a potential modifying factor both in CVD and depression, as well as in COVID-19 short- and long-term outcomes, particularly in cases involving long-term COVID complications. Results from emerging studies indicate that COVID-19 pandemic affected male and female populations in different ways. Women seem to experience less severe short-term complications but suffer worse long-term COVID complications, including depression, reduced physical activity, and deteriorating lifestyle habits, all of which may impact CV risk. Here, we summarize the current state of knowledge about the interplay between COVID-19, depression, and CV risk in women